REPOST: A Woman's Guide To Stroke Prevention

The American Heart Association published a new set of guidelines that focus on preventing stroke in women. The organization highlights the importance of medical history management and early lifestyle changes in stroke prevention. Forbes has the full story below.

(Photo credit: Wikipedia) Image Source: forbes.com

A new guideline published in the American Heart Association’s journal Stroke focuses on preventing stroke in the more stroke-prone sex: Women. Though the risk factors for stroke are in large part similar for women and men, women have some additional variables that put them at slightly higher risk throughout their lives. Part of the reason that women are more susceptible than men is simply due to the fact that they live longer. But other factors are largely hormone-related, and relevant to all stages of life.

Stroke is the fifth leading cause of death for men, but for women it’s the third leading cause. Women also tend to have poorer recovery than men, and more residual effects of stroke. They’re also more likely be institutionalized after stroke. Stroke typically occurs when a blood clot forms in a blood vessel going to the brain, thereby depriving it of oxygen.

Changes in the levels of reproductive hormones at different stages of life can affect a woman’s risk of stroke, and this is true for contraceptive hormones at a young age and hormone replacement therapy during menopause. Certain conditions, like preeclampsia, which can significantly raise blood pressure during pregnancy, put a woman at higher risk of stroke both during pregnancy and beyond.

“Women have very unique risks,” said author of the guidelines Cheryl Bushnell, “and they include pregnancy and the complications that can occur with pregnancy, in addition to a high blood pressure during pregnancy, which is preeclampsia and eclampsia. Then there are the issues related to hormonal use such as oral contraceptives and hormones that are used to help treat the symptoms of menopause.”

Here are the major points of the new guidelines:

• Women with a history of high blood pressure before pregnancy may be candidates for low-dose aspirin (81 mg) after the first trimester, and/or calcium supplements, to reduce the risk of preeclampsia – dangerously high blood pressure during pregnancy.
• Preeclampsia confers twice the risk of stroke and four times higher risk of high blood pressure later in life. Its stroke risks last well after pregnancy, so doctors should consider it a risk factor just like the classic ones: Cholesterol, smoking, and obesity.
• Doctors should consider treating pregnant women with moderately high blood pressure (150-159 mmHg/100-109 mmHg) with medication. Pregnant women with severely high blood pressure (160/110 mmHg or above) should generally be treated (some medications are not safe during pregnancy, however).
• Before starting birth control pills, women should be screened for high blood pressure, since the hormones in birth control can increase the risk of stroke.
• Women who have migraines with aura should stop smoking to avoid higher stroke risks. Migraine headaches that are accompanied by aura have been linked to increased stroke risk.
• Women over the age of 75 should be screened for atrial fibrillation, as it is associated with higher stroke risk.
• Hormone therapy during menopause may increase the risk of stroke, although the data are conflicting. But hormone therapy should not be used to prevent stroke.
• Psychosocial stress and depression are more common in women than in men, and are associated with significantly higher risk of stroke.

The take-home message is that prevention should be started earlier than it often is – young women should be thinking about stroke prevention, and talking about it with their doctors. Tracking and managing high blood pressure from an earlier age is the key, according to the authors. So is treating high blood pressure somewhat more aggressively (within reason) during pregnancy.

As always, lifestyle changes are the best ways to reduce the risk of stroke. And these healthy behaviors – eating well, exercising, and not smoking – should be a lifetime endeavor.

“We have a sedentary society, unfortunately,” said Bushnell. “I would emphasis exercise, eating right, and the American Heart Association has the whole Life’s Simple 7. And that’s what I would emphasize for younger women – and all women – who may be at risk for stroke. We’re trying to improve the general health of the population. So all of those actions will help prevent stroke in the future – especially for women.”


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REPOST: For young athletes, injuries need special care

Sports medicine is a need for athletes of all ages to help their bodies heal from injuries quickly and get back to top form. Laura Landro of the Wall Street Journal writes about the growing need for physical medicine departments of pediatric hospitals to accommodate teen and preteen athletes.

Children's hospitals are expanding programs to care for a fast-growing category of young patients: injured athletes.

Kaylyn Lambertt, a high-school soccer player and now a freshman at Florida State University, had surgery on her left hip her junior year and her right hip her senior year. Image source: wsj.com

The rehabilitation needs of children and teens are different than those of adults. More sports medicine programs are working exclusively with young athletes, using surgical techniques and physical therapy protocols that don't interfere with growing bones and cartilage.

One aim of this is to prevent affecting the growth plate—the area of growing tissue near the end of long bones in children and teens. For example, while adults may lift heavier weights to build muscle during physical therapy, pediatric patients may do higher repetitions with lower resistance to avoid hurting growing bones, muscles and tendons. The programs also offer encouragement and support for kids upset to be sitting out of a beloved sport.

More than 3.5 million children a year receive treatment for sports injury, according to Stop Sports Injuries, a campaign whose backers include the American Orthopaedic Society for Sports Medicine. And high-school athletes account for an estimated 2 million sports injuries each year. While concussions account for about 15% of youth sports injuries, experts say many sports carry risks for musculoskeletal injuries, in large part due to increased emphasis on year-round competition, single-sport concentration and intense training regimens.

A study published last year by Boston Children's Hospital warned that children of all ages are sustaining significant sports injuries that require surgical intervention. "In the past we'd put a cast on a broken leg, take it off six to 13 weeks later and send kids home," says Lyle Micheli, director of the hospital's division of sports medicine. "Now we realize we have to very systematically rehabilitate these kids for strength and basic function, and determine when it is safe for them to return to play."

Image source: wsj.com

While injuries from recreational activities such as biking have fallen over the last decade, team sports including football and soccer saw injuries rise by 22.8% and 10.8% respectively, according to a study last year by Cincinnati Children's Hospital Medical Center.

Doctors are seeing more overuse injuries. There has been a fivefold increase since 2000 in the number of shoulder and elbow injuries among youth baseball and softball players, according to Stop Sports Injuries.

Children's Hospital & Research Center Oakland, in California, last fall opened a Sports Medicine Center for Young Athletes at its Walnut Creek campus. "It's hard for kids to do rehabilitation next to an 85-year-old stroke victim or a 75-year-old cancer patient," says Nirav Pandya, the center's director, and an orthopedic surgeon. The center and many other pediatric clinics offer classes and programs to help kids improve sports performance while avoiding injury.

Physical therapy after injury and surgery, such as repair to the anterior cruciate ligament in the knee, is covered by insurance for varying periods. After that, clinics may design a regimen children can perform at home or at a local fitness facility.

Jeremy Frank, a pediatric orthopedic surgeon at Memorial Healthcare System's Joe DiMaggio Children's Hospital in Hollywood, Fla., says that there is often little pain a week after minimally invasive ACL surgery, so young people "think they are good to go and don't realize they have six months of rehabilitation in front of them." Often, he says, there is a "bargaining moment" where his young patients try to get him to approve more activity than they are ready for. Patients are generally referred to Memorial's two U-18—for Under 18—physical rehabilitation clinics in Coral Springs, Fla., where therapists work with families and coaches to stress the importance of healing.

Dr. Frank, U-18's assistant director, says while the vast majority of athletes get back to sports and do well, there are times when a young patient sustains multiple injuries such as a third ACL tear. "You have arthritic changes in your knee, and you have to stop playing soccer," he says.

Dylan Rupert, 17, a running back and captain of the Cypress Bay High School football team in Weston, Fla., tore his ACL during play last fall. His parents opted for a repair technique, which surgeons are more often using in pediatric patients. The procedure avoids drilling through the growth plate and may decrease risks of future pain and re-injury. The surgery used part of Dylan's own hamstring rather than a cadaver tissue more commonly used in adults. He started rehab at Coral Springs three days after his Oct. 22 surgery.

The injury was devastating for Dylan. It came just as he was getting the attention of college coaches, says his mother, Monica Puga-Finch, an information technology program director at the clinic's parent Memorial. In his first physical therapy session, senior therapist Whitney Chambers helped calm his fears, but "told him that she was going to push him, and he couldn't say 'I can't.' " As the sessions continued twice a week he would often come out sweating and sore but excited, "with a sense of accomplishment," Ms. Puga-Finch says. Ms. Chambers helped with the emotional aspects of being sidelined, encouraging him to go to practices and games with his team. His rehabilitation is expected to take six to eight months. He plans to return to sports in college.

Ms. Chambers says physical therapy after the growth-plate sparing procedure is more conservative than for the traditional ACL reconstruction. It starts with protective weight bearing exercises using crutches and a knee brace, gentle range of motion work, and ice and electrical stimulation for swelling and pain control. Then she works on strengthening muscles and restoring joint flexibility. To make it more fun, she uses games or obstacle courses.

The clinic uses screening questionnaires to identify kids at risk of depression, who may be referred to a child psychologist.

Kaylyn Lambertt who has played soccer from the age of 6, was a junior in high school when she felt a searing pain in her left hip during a game in December 2010. She continued to play for months as it got worse. Her labrum, part of her hip joint, was torn in two places, with a socket out of place. A lump on her bone was wearing down the cartilage every time she walked or ran. She had surgery to repair the damage in 2011, followed by months of rehabilitation with Ms. Chambers.

She returned to soccer her senior year, but began feeling pain, this time in her right hip. Dr. Frank told her that she had torn the labrum. She underwent a second surgery in December 2012. She returned to Ms. Chambers and realized during their talks that "soccer isn't everything." Now a freshman at Florida State University she plays a pickup game of soccer now and then, but is focused on what Ms. Chambers inspired her to chose as a career: physical therapy.

Dr. Mary Kneiser has behind her two decades worth of experience as a physical medicine and rehabilitation specialist. Visit this Facebook page for more updates.

REPOST: Amputees help advance thought-controlled prosthetic technology

Losing a limb is a traumatic event for most people who go through it. Moving forward usually requires a lot of time and support. Fortunately, there are many paths towards recovery and rehabilitation and this includes prosthesis. The Baltimore Sun reports on an interesting new development in prosthetic technology: thought control.

  

Video: A doctor at Johns Hopkins is working on the development of thought-controlled robotic arms to aid amputees. (Kim Hairston/Baltimore Sun video) | Video source: The Baltimore Sun

One minute, Anne Mekalian's brain is telling her prosthetic arm to unstack a set of multicolored plastic cones, and the shiny black metal limb is listening. Every now and then, the plastic clatters to the table, but quickly the cones are separated and restored to a neat pile.

The next moment, though, the bionic hand doesn't know what to make of slight muscle movements in Mekalian's forearm, interpreted through a set of electrodes touching the skin on the rounded remnant limb that extends just below her elbow. Instead of pinching a red clothespin, the robotic hand spins like Linda Blair's head in "The Exorcist."

"This is why it's experimental, right?" Mekalian, of Joppatowne, joked to a group of scientists who had gathered in an office at Johns Hopkins Hospital to watch her as part of clinical trials of advanced prosthetics.

Despite occasional setbacks — and, perhaps, because of them — the technology is advancing quickly. Over the past several months, Mekalian and two other amputees working with a Johns Hopkins Hospital surgeon and local company have been among the first in the nation to take home thought-controlled robotic arms designed for wounded veterans.

While the devices haven't been perfect replacements for limbs lost, they have brought a glimpse of what patients took for granted before being struck by infection, cancer or violence. Trial and error applying the technology to their daily lives — putting on makeup, cooking, carrying a laundry basket — is leading to refinements. The scientists say the technology could be available within a couple of years to countless others commercially, with plans for U.S. Food and Drug Administration review next year.

Before that can happen, the scientists are learning all they can through the 67-year-old Mekalian and the others.

"We're almost inventing a new field of medicine," said Dr. Albert Chi, a Johns Hopkins trauma surgeon working with the patients. "We're kind of learning as we go. There's no textbooks out there."

Read the entire article here.

Dr. Mary Kneiser and physical medicine experts await this newest development in prosthetic technology eagerly as this may mean better things for amputees. For more on physical rehabilitation, follow this Facebook page.

REPOST: Spinal cord injury: Levels, symptoms & treatment

LiveScience.com's Tanya Lewis writes about the injuries that may affect the spinal cord and the treatments used to address them.

The spinal cord is a bundle of nerves that extends from the brain and runs down the middle of the back. It sends signals to and from the brain and the rest of the body. It is a soft tissue surrounded and protected by the vertebrae in the spine.

Shown here is the nervous system, containing the brain, spinal cord and peripheral nerves.
Image source: LiveScience.com

A spinal cord injury is caused by damage to any part of the spine, including to the vertebrae, ligaments or disks, or the spinal cord itself. Spinal cord injuries can cause permanent loss of function below the level of the injury, including paralysis.

The incidence of spinal cord injury among survivors is about 40 cases per million in the United States, or about 12,000 new cases per year, according to the National Spinal Cord Injury Statistical Center (NSCISC). Estimates of the number of people in the United States living with spinal cord injuries range from 238,000 to 332,000.


Causes

A sudden blow to the spine that fractures, dislocates, crushes or compresses the vertebrae can cause traumatic spinal cord injuries. A gunshot or knife wound can also cut the spinal cord. During the weeks following the injury, bleeding, swelling, inflammation and fluid buildup in or near the spinal cord often cause further damage.

Diseases such as arthritis, cancer, inflammation, infections or degeneration of spinal disks can cause nontraumatic spinal cord injuries.

NSCISC lists the following causes of spinal cord injury since 2010:

• Motor vehicle accidents (36.6 percent)
• Falls (28.5 percent)
• Violence (14.3 percent)
• Sports (9.2 percent)
• Other/Unknown (11.4 percent)

Spinal cord injury levels

Spinal cord injuries vary in their location and severity. The "level" of injury refers to the lowest part of the spinal cord with normal function. Higher-level injuries affect the arms, hands, trunk, legs and pelvic organs, whereas lower-level injuries affect only the legs, pelvic organs and trunk. These can result in paralysis of all four limbs (tetraplegia or quadriplegia) or paralysis of the lower limbs (paraplegia).

The severity of the injury is classified as either complete, in which nearly all movement and sensation below the level of the injury is lost, or incomplete, in which some residual movement and sensation remains.

Image source: LiveScience.com

Symptoms

Symptoms of spinal cord injury include:

• loss of movement
• loss of sensation (sense of touch, heat or cold)
• loss of bowel or bladder control
• exaggerated reflexes or spasms
• changes in sexual function or sensitivity
• pain or stinging due to nerve damage
• difficulty breathing, coughing, or clearing the throat

Emergency symptoms of an injury include:

• severe pain or pressure in the neck, head or back
• weakness, lack of coordination or paralysis of part of the body
• numbness, tingling or loss of feeling in the hands and feet
• loss of bladder or bowel control
• difficulty walking or balancing
• difficulty breathing after the injury
• a twisted neck or back

People with these symptoms should seek immediate medical attention.

Treatment

Treatment options are limited, but prosthetic technologies and therapeutic drugs that may help nerve cells regenerate or improve how well remaining nerves function are being developed.

Immediately after an accident, emergency responders immobilize the spine using a stiff neck collar and carrying board in order to transport the patient. Emergency treatment involves maintaining breathing ability, preventing shock, keeping the neck immobilized, and preventing complications such as blood clots.

Once a patient is diagnosed with a spinal cord injury, they may receive medications, such as Methylprednisolone (Medrol), which can cause mild improvement in some patients, if taken within eight hours of injury. Doctors may use traction (often by attaching metal braces and weights to the skull to prevent it moving) to stabilize the spine and/or realign it. Surgery may be needed to remove fragments of bone, herniated disks, fractured vertebrae or foreign objects, or to stabilize the spine to minimize pain or future deformity.

A variety of experimental treatments may also be available.

Rehabilitation

A team of therapists and specialists work with patients during their early stages of recovery. Physical therapists focus on having the patient maintain and strengthen existing muscle function, while occupational therapists, rehab psychologists and others help the patient learn basic tasks and new skills.

Modern technology can provide some independence to individuals living with spinal cord injury. Assistive equipment includes wheelchairs, computer adaptations, electronic aids, robotic gait training and electrical stimulation.

Researchers are currently developing neural prostheses, known as brain-computer interfaces. These systems use electrodes on the scalp or implanted in the brain, which record electrical signals from neurons and translate them into control of a computer or prosthetic limb. The technology is still in its early stages, however, and not available for general use.
  
Get more updates on physical medicine and related disciplines from this Mary Kneiser blog. 

REPOST: What Kids Should Know About Spinal Injuries in Sports

Laura Landro discusses efforts to raise awareness of a little-understood but dangerous risk to young athletes: injuries to the cervical spine which can lead to paralysis or even death. More from this Wall Street Journal article.

There is a new push to alert high school athletes about neck injuries.
(Image source: wsj.com)

It could be a hard tackle in football, a cross-check in ice hockey or a fall off the top of a cheerleading pyramid.

A new push is under way to raise awareness of a little-understood but dangerous risk to young athletes: injuries to the cervical spine, the highly vulnerable area between the first and seventh vertebrae that protects the spinal cord connecting the brain to the body. Players and teammates may not instantly recognize the severity of the damage, and the wrong move can damage or sever the spinal cord, resulting in paralysis or even death.

In addition to programs to educate coaches, parents and students, a number of groups are pressing for more certified athletic trainers who are qualified to quickly recognize and respond to spinal and other injuries.

Though less common than concussions, cervical-spine injuries most often occur when players in contact sports lower their head or tuck their chin into their chest and collide with another player, the ground or objects such as goal posts. While players often recover from injuries such as fractures of one or more vertebrae, commonly referred to as a broken neck, cervical spine injuries can also be quickly fatal.

De'Antre Turman, a 16-year-old Atlanta-area high school football player, died in August after being injured during a scrimmage, suffering a fracture to his third vertebra on the field, Fulton County Medical Examiner investigator Mark Guilbeau said in a telephone interview.

San Diego-based Athletes Saving Athletes co-founder Tommy Mallon, kneeling, conducts a demonstration with volunteer Danny Kolts during a 2012 seminar.
(Image source: wsj.com)

The Centers for Disease Control and Prevention estimate as many as 20,000 spinal-cord injuries occur annually in the U.S., with sports accounting for about 12%, and new cases most often occurring in 15-to-35-year-olds.

Robert Cantu, chief of neurosurgery at Emerson Hospital in Concord, Mass., and medical director of the National Center for Catastrophic Sports Injury Research at the University of North Carolina at Chapel Hill, says new rules put in place in 1976 to discourage headfirst contact in football—known as "spearing"—aren't consistently followed.

The number of reported cervical-spine injuries that lead to permanent or temporary neurological damage, such as partial or complete paralysis, remains small but appears to be on the rise. The center's Annual Survey of Catastrophic Football Injuries in high school and college last year found that in four of the previous 10 years, the number of such injuries that led to some paralysis was in the double digits—14 in 2008, for example—after dropping into the single digits throughout the 1990s. Many severe spinal-cord injuries in sports also go unreported, Dr. Cantu says.

Coaches who were surveyed told the researchers that they teach players to tackle with the head up, but many players still lower their heads before making contact and many ball carriers are injured with their heads down.

"There is a sense of invulnerability in young athletes who think it's not going to happen to them," says Ron Courson, director of sports medicine at the University of Georgia. In addition to training players on proper blocking and tackling techniques, his team practices injury response scenarios on the field with trainers, physicians and emergency responders before football season begins.

At Penn-Trafford High School in Harrison City, Pa., there are three athletic trainers on staff for the 1,600 athletes in grades 9 to 12, says Larry Cooper, head athletic trainer. Parents can attend classes for coaches about injury risks and a sports emergency action plan is available on the school's website.

While college athletic programs nearly always have athletic trainers on staff, the National Athletic Trainers' Association says only two-thirds of U.S. secondary schools with athletic programs have access to full- or part-time athletic trainers, who are typically licensed by the state and work under the direction of physicians. That's up from 40% to 45% in 2005, but leaves a third of schools without one, the nonprofit association says. The group is conducting a state-by-state ranking of public schools and a similar study on private schools to determine why schools don't have trainers. (Expense is one factor.) The group also is analyzing the medical care available at games when an athletic trainer isn't present.

Athletes Saving Athletes graduate Tucker Boucher, left, with fellow San Diego-area student-athletes. ASA focuses on sports safety education and injury prevention.
(Image source: wsj.com)

"Parents who would never leave their kids off at a public swimming pool without a lifeguard think nothing about dropping them off at football or soccer without an athletic trainer. But they need to ask who is taking care of their kids when they are participating in these sports," says Jim Thornton, president of the athletic trainer association and director of sports medicine and athletic training at Clarion University in Clarion, Pa.

The association issued recommendations for management of cervical-spine injuries in athletes in 2009 which include special care in removing a helmet, face mask and shoulder pads and immobilization techniques on the field. Erik Swartz, an athletic trainer and associate professor at the University of New Hampshire who co-wrote the recommendations, says one of the highest risks in a spine injury is moving an athlete.

Tommy Mallon, now 22, collided with another player during a lacrosse game in 2009 at Santa Fe Christian high school in Solana Beach, Calif. A teammate ran to his side but fortunately didn't attempt to help him up until athletic trainer Riki Kirchhoff got to the scene. She kept Mr. Mallon on the ground until emergency medical responders arrived.

At the hospital, he was diagnosed with a fracture in his spine at the C1 vertebra and a damaged artery restricting blood flow to the brain. After months of grueling rehabilitation, including traction in a massive "halo" device to immobilize his head and neck and physical therapy, he was able to start classes at the University of San Diego in the spring of 2010. Though he won't be able to play contact sports again, he sustained no permanent neurological damage.

Mr. Mallon and his mother, Beth Mallon, a photographer who was at the game when his injury occurred, formed a nonprofit group, Advocates for Injured Athletes, to help other families navigate the challenges of injuries and lobby for certified athletic trainers at every high school.

Last year the Mallons also launched Athletes Saving Athletes, a program which offers classes taught by athletic trainers to help student-athletes understand signs and symptoms of different types of sports injuries and conditions. About 1,500 athletes in the San Diego area have participated and Ms. Mallon aims to expand the program. "We can educate athletes to recognize basic symptoms, and if they suspect a neck injury, don't move them. Don't touch them. Just stay with them until help arrives," she says.

Tucker Boucher, 16-year-old junior at Cathedral Catholic High School in San Diego, says after going through the program, he talked to his lacrosse team about risks and how to recognize symptoms of injury. His mother, Annie Boucher, who also attended a session, says the training "empowers these kids with knowledge of certain situations that can save somebody's life."

Dr. Mary Kneiser works with athletes as they regain their strength and form after suffering an injury. Learn more how physiatrists help injured athletes get back on their feet on this Facebook page.

REPOST: Children who live in "smart growth" neighborhoods get 46% more physical activity

A study by the American Journal of Preventive Medicine shows that children living in places close to parks and green space areas get 46% more physical activity compared to those who do not. News-Medical.net reports on the study's findings. 

Image Source: cdn.sheknows.com

Children who live in "smart growth" neighborhoods--developments that are designed to increase walkability and have more parks and green space areas--get 46 percent more moderate or vigorous physical activity than kids who live in conventional neighborhoods, finds a study in the American Journal of Preventive Medicine.

"We were surprised by the size of the effect," said Michael Jerrett, Ph.D., professor in the School of Public Health at the University of California, Berkeley and lead author on the study. He and his colleagues evaluated activity patterns in children aged 8 to 14 who recently moved to a smart growth community called The Preserve near Chino, CA. The researchers compared them with children living in eight nearby conventional communities, matched for ethnicity and family income.

The children wore small accelerometers and global positioning system (GPS) devices to measure their activity levels and determine how much activity occurred outside the home but within the neighborhood. The devices collected and recorded information about their physical activity for seven days and determined that living in a smart growth community would add 10 minutes of activity for each child each day.

"Ten minutes of extra activity a day may not sound like much, but it adds up," said Jerrett. Taking in as little as 15 calories more than you expend on a daily basis can lead to weight gain over time, he noted. A child who weighs 100 pounds might burn an extra 30 calories in those 10 extra minutes of physical activity each day. "The basic idea is that even small things count," he said.

Previous research has found that only 42 percent of children aged 6 to11 get the recommended amount of physical activity. This drops to 8 percent for those aged 12 to 19 years, Jerrett said. In fact, younger children in the smart growth community were 62 percent more active in their neighborhood than older children. Boys were 42 percent more active in the smart neighborhood than girls, Jerrett said.

The conclusions of the study are very consistent with current thinking and research, commented Kaid Benfield, director of sustainable communities at the Natural Resources Defense Council in Washington, D.C. Smart communities are being planned and created, but existing communities can be retrofitted to be smarter and encourage more exercise, he reported.

"The best way to retrofit suburbs is to redevelop parcels of land that become available as strip malls, big-box shopping, and regional malls go out of service - replacing them with more walkable, mixed-use development."

Mary Kneiser is a physical medicine and rehabilitation specialist who has been helping patients for more than two decades now. Know more about her professional career by visiting this Facebook page.

Boxing? Bring your boxing shoes first

Image Source: boxingscene.com

The unbelievable feats and global renown of Filipino boxing champion Manny Pacquiao are largely credited for restoring popular interest in boxing, after seasons of slumping ticket sales in the sport. Boxing is also moving out of the professional ring, for many fitness enthusiasts consider it effective for trimming down and becoming healthier.

However, in line with the easy recreational culture surrounding boxing these days, there seems to be little regard for the sport’s modicum : there are too few available boxing shoes in the market, and many boxing gyms today teem with “boxers” wearing inappropriate shoes. Certainly, tennis, cross training—even slacker sportswear Chuck Taylors—and basketball shoes aren’t suitable for the canvas. Especially not for a physically demanding and ankle-breaking sport like boxing.

Image Source: boxingsocialist.com

Wearing proper shoes in the boxing ring has benefits.

For safety purposes, boxing shoes are the perfect cushion for running on the slippery canvas. Also, boxing is a sport that demands a lot of rhythmic footwork. Wearing shoes that are designed for frequent pivoting of the ankles protects the boxer from foot injuries.

Apart from feet protection, comfort is the main idea behind the ergonomics of boxing shoes. These are manufactured with lightweight and non-slip rubber that articulates perfectly with the canvas.

Image Source: ultfitev.com

Lastly, aesthetics: Oscar dela Hoya in basketball shoes would be laughed out of the ring, and recreational boxers may well look the part. The elongated, slick, and classy design of boxing shoes is beyond ergonomics. Manny Pacquiao’s image is burnished by the distinctive aura lent by his boxing shoes.


As a physiatrist, Dr. Mary Kneiser believes in the importance of wearing proper sports attire to avoid physical injuries. Follow this Twitter page for more information on physical medicine and rehabilitation.